Candesartan

DEA Class; Rx

Common Brand Names; Atacand

• ARBs

Angiotensin II receptor blocker (ARB)
Used for hypertension (HTN) and to treat heart failure in adults
Also used to treat HTN in pediatric patients 1 year of age and older

Indicated for the treatment of hypertension.

Hypersensitivity

Severe hepatic impairment

Do not coadminister with aliskiren in patients with diabetes

• Peripheral edema
• Dizziness
• Hypertriglyceridemia
• Hyperuricemia
• Fatigue
• Abdominal pain
• Diarrhea
• Nausea
• Arthralgia
• Back pain
• Chest pain
• Angina
• Tachycardia
• MI
• Palpitation
• Albuminuria
• Bronchitis
• Coughing
• Pharyngitis
• Dyspepsia
• Gastroenteritis
• Rhinitis
• URI
• Rash
• Angioedema

History of angioedema

Hypovolemia

Risk of hypotension, especially in hypovolemic/hyponatremic patients, concomitant diuretics, dialysis, or during major surgery

Renal deterioration may occur

Discontinue immediately with pregnancy (see Black Box Warnings)

Caution in patients with CHF; may need to adjust dose

Hyperkalemia may occur with renal failure or drugs that increase potassium levels; monitor serum potassium levels periodically

Dual blockade of the renin angiotensin system with ARBs, ACE inhibitors, or aliskiren associated with increased risk for renal function changes (including acute renal failure) compared to monotherapy

Risk of anaphylactoid reactions and/or angioedema

Caution in hepatic impairment, hypercholesterolemia, hypercalcemia, parathyroid disease, pre-existing renal insufficiency, systemic lupus erythematosus, anuria

Caution in patients with aortic/mitral stenosis

Caution in patients with unstented unilateral/bilateral artery stenosis

Infants <1year must not receive candesartan; may have effects on the development of immature kidneys

In-utero exposure in neonates: If oliguria or hypotension occur, exchange transfusions or dialysis may be required to reverse hypotension and/or substitute for disordered renal function

Therapy can cause fetal harm when administered to a pregnant woman; use of drugs that act on renin-angiotensin system during second and third trimesters of pregnancy reduces fetal renal function and increases fetal and neonatal morbidity and death

Not known whether drug is excreted in human milk, but shown to be present in rat milk; because of potential for serious adverse reactions in breastfed infants, advise a nursing woman that breastfeeding is not recommended during therapy